vanSonnenberg E, Wittich G R, Casola G, Stauffer A E, Polansky A D, Coons H G, Cabrera O A, Gerver P S
Radiology. 1985 May;155(2):335-40. doi: 10.1148/radiology.155.2.2580332.
Diagnostic and therapeutic interventional radiology techniques in 41 patients with complications of pancreatic inflammatory disease (noninfected pseudocyst, infected pseudocyst, phlegmon, abscess, hemorrhagic pancreatitis) are described. Computed tomography or ultrasound-guided aspiration or percutaneous pancreatic ductography enabled specific diagnoses in 43 of 45 patients (96%). In almost half the patients, diagnostic aspiration with 22-gauge needles was unsuccessful due to viscous contents or firm cavity walls. Single-step needle aspiration of noninfected pseudocysts was successful in only three of ten patients (30%). Catheter drainage cured six of seven noninfected pseudocysts (85.7%) and seven of nine infected pseudocysts (77.7%). Pancreatic phlegmons were aspirated in five patients to exclude secondary infection and help determine the need for surgery. Pancreatic abscesses were drained successfully in nine of 13 patients (69.2%); temporizing benefit was achieved in the other four who eventually underwent surgery in improved condition. Early diagnosis of the complications of pancreatitis may be established almost uniformly, and at least 70% of patients with infected or noninfected pseudocysts and pancreatic abscesses may be cured by nonoperative drainage.
本文描述了41例胰腺炎性疾病并发症（非感染性假性囊肿、感染性假性囊肿、蜂窝织炎、脓肿、出血性胰腺炎）患者的诊断和治疗性介入放射学技术。计算机断层扫描或超声引导下穿刺抽吸或经皮胰管造影在45例患者中的43例（96%）实现了特异性诊断。在近一半的患者中，由于内容物黏稠或腔壁坚硬，使用22号针进行诊断性穿刺抽吸未成功。10例非感染性假性囊肿患者中，单步针吸仅3例成功（30%）。导管引流治愈了7例非感染性假性囊肿中的6例（85.7%）和9例感染性假性囊肿中的7例（77.7%）。对5例胰腺蜂窝织炎患者进行穿刺抽吸以排除继发感染并帮助确定是否需要手术。13例胰腺脓肿患者中9例成功引流（69.2%）；另外4例暂时受益，最终在病情改善后接受了手术。胰腺炎并发症几乎均可实现早期诊断，并且至少70%的感染性或非感染性假性囊肿及胰腺脓肿患者可通过非手术引流治愈。
